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Report of Ventilatory Study; Roentgenographic Interpretation; Medical History and Examination of Coal Mine Workers' Pneumoconiosis; Report of Arterial Blood Gas Study

IC 13761 under ICR 199601-1215-001 · OMB 1215-0090.

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Information Collection (IC) Details

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IC Title:	Report of Ventilatory Study; Roentgenographic Interpretation; Medical History and Examination of Coal Mine Workers' Pneumoconiosis; Report of Arterial Blood Gas Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CM-988	No	No
Form	CM-933	No	No
Form	CM-907	No	No
Form	CM-933B	No	No
Form	CM-1159	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 37,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	37,800	490	9,310	28,000
Annual IC Time Burden (Hours)	9,338	121	2,300	6,917
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.